Download Journal of Psychoactive Drugs

JOURNAL OF PSYCHOACTIVE DRUGS
A BRIEF HISTORY
In the summer of 1967 a new periodical appeared "to compile and disseminate objective information relative to
the various types of drugs used in the Haight-Ashbury subculture." Conceived and edited by David E. Smith,
M.D., the Journal of Psychedelic Drugs, which began as a house organ for the Haight-Ashbury Free Medical
Clinic of San Francisco, found its geographical focus rapidly expanding as the use of psychedelics and other
psychoactive drugs (especially LSD and marijuana) spread throughout the nation and around the world. The
Journal's topical focus shifted also, reflecting the replacement of the Haight-Ashbury district's hippie subculture
and its use of psychedelic drugs with a scene predominated by high-dose intravenous amphetamine users, who
either burned out or turned to the use of other drugs, such as barbiturates and heroin, in an effort to ameliorate
the speedy effects of the stimulants. Similar patterns of drug abuse began to appear in other urban centers as
well. Hundreds of free clinics, hotlines and drug information/education centers emerged to provide this largely
youthful population with confidential, credible and nonjudgmental services, which at that time were unavailable
from traditional medical, social service, and mental health agencies.
The directors of the Student Association for the Study of Hallucinogens, Inc. (STASH) – a Wisconsin-based
drug information resource center – approached Dr. Smith in June of 1970 with the idea of entering into a
cooperative arrangement to publish the Journal of Psychedelic Drugs and to expand the periodical's
distribution. It was agreed that, beginning with Volume 3, Number I (September 1970), the Journal's
publication, subscription, and general business offices would be moved to STASH headquarters in Beloit,
Wisconsin. The editorial responsibility for the Journal's content would alternate between the Haight-Ashbury
Free Medical Clinic and STASH.
This collaboration led to the successful expansion of the Journal in 1974 (Volume 6) to a regular quarterly
schedule and the establishment of a professional Editorial Review Board to provide peer assessment in the
selection of articles. To mark this occasion and to further delineate the scope of the Journal of Psychedelic
Drugs, the subtitle "A Multidisciplinary Forum for the Study of the Drug Culture" was adopted.
During the late 1970s the Journal of Psychedelic Drugs built an international reputation as a respected and
authoritative periodical. This was corroborated by the inclusion of the Journal in the prestigious Index Medicus
in 1979. In 1981 the Journal returned to its birthplace in the Haight-Ashbury district of San Francisco under the
aegis of David E. Smith, M.D., Founder and Medical Director of the Haight-Ashbury Free Medical Clinics, and
the continued editorship of E. Leif Zerkin, Cofounder and Codirector of STASH. At the same time, the
Journal's title was changed to the Journal of Psychoactive Drugs to better reflect the broad scope of its
contents. In 1982, Jeffrey H. Novey joined the editorial staff as coeditor. After a distinguished editorial tenure
of more than twenty years, Leif Zerkin moved on to other pursuits and new challenges. In October 1991, the
responsibilities of managing editor passed to Jeffrey Novey. In December 1991, Terry Chambers joined the
journal staff and is currently associate editor. In September 1996, Jeffrey Novey left to pursue further academic
achievements and Richard B. Seymour, a long-term contributor to the Journal, became managing editor.
Throughout its thirty year history, the Journal of Psychoactive Drugs has been on the leading edge of developments in the field of drug use, abuse, and treatment. It has consistently addressed the complex nature of
substance use and abuse from a multidisciplinary perspective and has provided in-depth examination of a host
of topics, including the disease concept of addiction, drug use and criminality, drug use and the elderly, drug
use and sexual behavior, ethnographic drug research, the history of cocaine smoking, therapeutic communities,
hallucinogens, stimulants, depressants, smokable drugs, drug dependence and the family, women and substance
abuse, professional treatment and the 12-Step process, chemical dependence and AIDS, shamanism and altered
states, dual diagnosis, psychotherapy/counseling, adverse effects of tobacco smoking, understanding and
preventing relapse, substance abuse in the workplace, drug testing, methadone maintenance treatment,
prescription drug issues, and culturally relevant substance abuse treatment. The Journal continues to serve both
professionals and laypersons alike as an important multidisciplinary forum for critical thinking, analysis,
innovation, and evolutionary development in the field of drug use, abuse, and treatment.
Reward Deficiency Syndrome:
A Biogenetic Model for the Diagnosis
and Treatment of Impulsive, Addictive,
and Compulsive Behaviors
Kenneth Blum, Ph.D.*; Eric R. Braverman, M.D.**; Jay M. Holder, D.C.***;
Joel F. Lubar, Ph.D.****; Vincent J. Monastra, Ph.D.*****; David Miller, M.A.******; Judith O.
Lubar, M.S.W.*******; Thomas J.H. Chen, Ph.D.********
& David E. Comings, M.D.*********
*Adjunct Professor, Department of Biological Sciences, University of North Texas, Denton, Texas;
President and CEG, PhamcoGenomics, San Antonio, Texas; Medical and Scientific Director, Department of
Clinical Sciences, PATH Medical Foundation, New York, New York; Cofounder and Vice President, American
College of Addictionology and Compulsive Disorders, Miami Beach, Florida; Board of Directors, PATH
Foundation and ACACD.
**Medical Director, Department of Clinical Sciences, PATH Medical Foundation, New York, New
York; Department of Psychiatry, New York School of Medicine, New York; Board of Directors PATH
Foundation.
***Cofounder and President, American College of Addictionology and Compulsive Disorders, Miami
Beach, Florida; Department of Addiction Studies, Graceland University, Independence, Missouri; Chairman,
Department of Addiction Medicine, Exodus Israel/Bikur Cholim Hospital, Jerusalem, Israel.
****Professor, University of Tennessee, Knoxville, Tennessee.
*****Clinical Director, Family Psychology Institute & Attention Disorders Clinic, Endicott, New York.
******Ph.D. candidate and Adjunct Professor, Department of Addiction Studies, Graceland University,
Independence, Missouri.
*******Director, Southeastern Biofeedback Institute, Knoxville, Tennessee.
********Director, Toxicology Research Center, Chang Jung Christian University, Tainan, Taiwan,
Republic of China.
*********Chairman, Department of Medical Genetics, City of Hope National Medical Center, Duarte,
California.
Abstract – The dopaminergic system, and in particular the dopamine D2
receptor, has been implicated in reward mechanisms. The net effect of
neurotransmitter interaction at the mesolimbic brain region induces "reward"
when dopamine (DA) is released from the neuron at the nucleus accumbens and
interacts with a dopamine D2 receptor. "The reward cascade" involves the
release of serotonin, which in turn at the hypothalmus stimulates enkephalin,
which in turn inhibits GABA at the substantia nigra, which in turn fine tunes the
amount of DA released at the nucleus accumbens or "reward site." It is well
known that under normal conditions in the reward site DA works to maintain
our normal drives. In fact, DA has become to be known as the "pleasure
molecule" and/or the "antistress molecule." When DA is released into the
synapse, it stimulates a number a DA receptors (D1-D5) which results in
increased feelings of well-being and stress reduction. A consensus of the
literature suggests that when there is a dysfunction in the brain reward cascade,
which could be caused by certain genetic variants (polygenic), especially in the
DA system causing a hypodopaminergic trait, the brain of that person requires a
DA fix to feel good. This trait leads to multiple drug-seeking behavior. This is
so because alcohol, cocaine, heroin, marijuana, nicotine, and glucose all cause
activation and neuronal release of brain DA, which could heal the abnormal
cravings. Certainly after ten years of study we could say with confidence that
carriers of the DAD2 receptor A1 allele have compromised D2 receptors.
Therefore lack of D2 receptors causes individuals to have a high risk for
multiple addictive, impulsive and compulsive behavioral propensities, such as
severe alcoholism, cocaine, heroin, marijuana and nicotine use, glucose
bingeing, pathological gambling, sex addiction, ADHD, Tourette's Syndrome,
autism, chronic violence, posttraumatic stress disorder, schizoid/avoidant
cluster, conduct disorder and antisocial behavior. In order to explain the
breakdown of the reward cascade due to both multiple genes and environmental
stimuli (pleiotropism) and resultant aberrant behaviors, Blum united this
hypodopaminergic trait under the rubric of a reward deficiency syndrome.
Keywords-dopamine D2 gene, genetics, impulsive, addictive and compulsive
behaviors, neurotransmitters, reward deficiency syndrome
A SUBLUXATION MODEL FOR REWARD
DEFICIENCY SYNDROME BEHAVIORS
To date there are no published reports which
support the potential use of chiropractic care for
individuals suffering from substance use disorder or
any other impulsive, addictive, or compulsive
behavior. However, there is one report (Blanks,
Schuster & Dobson 1997) on 2,819 subjects, which
lead the authors to conclude that network care
(chiropractic) increased well-being in the studied
population. The data collected involved a self-rated
wellness and quality of life survey. Nevertheless, our
subsequent remarks should be taken with caution in
terms of the clinical applicability of this technique to
treating RDS behaviors.
It is appropriate to first discuss research that
suggests the spine may be an anatomical extension of
the limbic system. The limbic system is the site
where feelings are mediated. These feelings are
expressed through the reward cascade model as first
proposed by Blum and Kozlowski (1990). We now
know many naturally occurring brain and spinal cord
substances play a role in both emotions and pain
reduction, leading to an increased sense of wellbeing.
In this regard, Pert and Diensfrey (1988) and Lewis
and colleagues (1981) suggested the limbic system
should include not only the amygdala and
hypothalamus, but also the dorsal horn of the spinal
cord. In fact they point out that a number of
neuropeptide receptors having psychophysiological
effects can be found in the dorsal horn of the spinal
cord. Burstein and Potrebic (1993) of the Department
of Neuro-Biology at the Harvard Medical School
provide evidence for direct projection of the spinal
cord neurons to the amygdala and orbital cortex.
Further, these authors suggest that these pathways
play a role in neuronal circuits that enable
somatosensory information, including pain, to effect
autonomic, endocrine, and behavioral functions.
Giesler, Katter & Dado (1994) found specific spinal
pathways which project to the limbic system for
nociceptive information, and these pathways seem to
include the hypothalamus bilaterally.
In unpublished work conducted prior to the
previously mentioned network study, Holder and
Blum decided to test the hypothesis that chiropractic
care goes beyond its known role in musculoskeletal
disorders. This is based on the speculation that via
adjustment of the spine, a subluxation free spine
would facilitate an enhanced sense of well-being via
limbic activation of dopamine release at the nucleus
accumbens. We therefore carried out preliminary
studies at the Exodus Treatment Center in Miami,
Florida, where we incorporated chiropractic
procedures (Torque Release Technique) to see if we
could significantly affect psychological states, drug
withdrawal, and patient retention rates in inpatient
Journal of Psychoactive Drugs
59-60
SUD residents. The investigation was a randomized
clinical trial, blinded and with a placebo control to
mimic the subluxation-based chiropractic treatment.
The study included 98 human subjects and consisted
of three groups: a standard residential treatment
group, a standard residential treatment group plus
chiropractic adjustments, and a standard residential
treatment plus placebo chiropractic adjustments. The
results analyzed reveal that chiropractic adjustments
are producing a significantly improved retention rate
within a 30 day residential model compared to both
the placebo and the standard groups, with a
statistically significant improvement in anxiety and
depression scores (based on a battery of seven
psychological inventories) when compared to sham
controls, as well as a significant reduction in nursing
station visits compared to controls. While these
results are intriguing and open to a number of
possible interpretations, the study needs to be
replicated by an independent laboratory before any
conclusions can be drawn.
Volume 32 Supplement, November 2000